Statement of Interest form for the 2024-25 LJI Program

Please complete and submit the Statementof Interest form below by the August 5, 2024 deadline.

Name of Organization

Address of Organization

Address

Address 2

City/Town

Province

Country

Primary Contact

Name

Phone

Eligibility Criteria

	Response
We are not-for-profit organization, owned and operated by the community:	We are not-for-profit organization, owned and operated by the community:
We produce and distribute audio-visual community media:	We produce and distribute audio-visual community media:
We train and facilitate community members and local organizations to create content as part of an open-access mandate:	We train and facilitate community members and local organizations to create content as part of an open-access mandate:
Our community is journalistically 'underserved' and experiencing news poverty:	Our community is journalistically 'underserved' and experiencing news poverty:
We can demonstrate a commitment to serve under-represented communities:	We can demonstrate a commitment to serve under-represented communities:

How long has your organization been in operation?

What motivated its establishment? (e.g. No sources of local information, no information in local language, spin-off of having community-owned tower supplying other services, educational institution, etc.)

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Statement of Interest form for the 2024-25 LJI Program